A MAO-B inhibitor for Parkinson's
Rasagiline
A once-daily MAO-B inhibitor used in Parkinson's disease, alone in early disease or added to levodopa to reduce 'wearing off'.
What is Rasagiline?
Rasagiline is a MAO-B inhibitor used to treat Parkinson's disease. It can be taken on its own in early disease or added to levodopa to reduce 'off' time when symptoms return between doses. It works by slowing the breakdown of dopamine in the brain.
Education and reference only. This is a plain-language guide to Rasagiline — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Rasagiline is a more modern MAO-B inhibitor taken once a day for Parkinson's disease. It can be used on its own in early disease to ease symptoms, or combined with levodopa later to reduce the periods when Parkinson's symptoms return before the next dose ('off' time). It is generally well tolerated and is used as a long-term part of a person's Parkinson's treatment.
How it works
Rasagiline blocks monoamine oxidase type B (MAO-B), the enzyme that breaks down dopamine in the brain. By slowing this breakdown, it leaves more dopamine available to support movement. Added to levodopa, this helps smooth out symptom control and reduce the 'wearing off' that can occur between levodopa doses.
Company & origin
Originated / developed by: Developed by Teva Pharmaceutical Industries..
Developed in Israel by Teva, building on research at the Technion, and approved in Europe and the US in the mid-2000s for Parkinson's disease.
What it treats
Conditions Rasagiline is used for
Practical use
How to take Rasagiline
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it once a day, with or without food, at a regular time.
- It can be used on its own or alongside levodopa, depending on your stage of Parkinson's.
- If added to levodopa, your levodopa dose may be reduced to limit involuntary movements.
- Keep taking it consistently; do not stop suddenly without specialist advice.
- Tell your prescriber about all other medicines, especially antidepressants and strong painkillers.
Weighing it up
Advantages & disadvantages of Rasagiline
Advantages
- Simple once-daily dosing that is easy to remember.
- Less likely than selegiline to disturb sleep.
- Reduces 'off' time and smooths symptom control when added to levodopa.
Disadvantages
- Can worsen levodopa-related involuntary movements (dyskinesia).
- Carries a risk of serious interactions with certain antidepressants and opioids.
- Like other Parkinson's medicines, must not be stopped abruptly.
Practical use
Good to know
Rasagiline is usually taken once a day, which makes it simple to fit into a routine, and it is less stimulating than selegiline so sleep is less often a problem. When added to levodopa it can increase levodopa-related involuntary movements (dyskinesia), which the levodopa dose can be adjusted to manage. As with all Parkinson's medicines, it should not be stopped abruptly.
Who should not take it / use with caution
- People taking certain antidepressants (such as SSRIs, SNRIs and other MAOIs) or the painkiller pethidine, due to the risk of a serious reaction.
- People with significant liver impairment need caution and specialist advice.
- Anyone whose specialist advises against it after reviewing their full medicine list.
Monitoring
- Review of Parkinson's symptoms and 'off' time.
- Watch for new or worsening involuntary movements.
- Watch for confusion, hallucinations or excessive daytime sleepiness.
Side effects
- Headache.
- Nausea, or dizziness on standing.
- Worsening of involuntary movements when used with levodopa.
- Confusion or hallucinations, more likely in older or frail people.
Key interactions
- Pethidine and some other opioids (such as tramadol) — risk of serotonin syndrome; avoid.
- SSRI, SNRI and other antidepressants — risk of serotonin syndrome; combinations need specialist caution or avoidance.
- Other MAO inhibitors — should not be combined.
- Sympathomimetic decongestants — can raise blood pressure.
Available as: Tablets.
Answers
Rasagiline: frequently asked questions
What is rasagiline used for?
It treats Parkinson's disease. It can be used alone in early disease or added to levodopa to reduce the 'off' periods when symptoms return between doses.
Is rasagiline better than selegiline for sleep?
Rasagiline is generally less stimulating than selegiline, so it is less likely to disturb sleep. It is also taken just once a day.
Can I take rasagiline with antidepressants?
Combining it with certain antidepressants such as SSRIs and SNRIs can cause a serious reaction called serotonin syndrome. Tell your specialist about every antidepressant before starting.
Does rasagiline cause involuntary movements?
When added to levodopa it can increase levodopa-related involuntary movements (dyskinesia). Your specialist can adjust the levodopa dose if this happens.
Can I stop rasagiline if I feel well?
No. Parkinson's medicines should not be stopped abruptly, as symptoms can worsen sharply. Any change should be made with your specialist.
The wider class
About MAO-B inhibitors
Rasagiline belongs to the mao-b inhibitors class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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